Rise of Outpatient Care: Where Hospitals are Investing

As hospitals and physician groups look to provide care in the most cost-effective setting, they are increasingly putting more capital dollars in areas outside of their traditional four walls.

That was the topic of discussion during a panel at the Becker's Hospital Review 5th Annual Meeting in Chicago May 15. The panel, moderated by Becker's Hospital Review Editor Bob Herman, included Mark Tambussi, senior vice president and national manager of PNC Equipment Finance; Michael Tretina, CPA, senior vice president and CFO of Bayhealth Medical Center in Dover, Del.; John Goodnow, CEO of Benefis Health System in Great Falls, Mont.; and Michael Kasper, CEO of DuPage Medical Group in Downers Grove, Ill.

When Mr. Goodnow joined Benefis about 12 years ago, 80 percent of the system's revenue was on the inpatient side, he said. Now, inpatient business accounts for a little more than 40 percent of the system's business. "All of our growth occurs on the outpatient side," he said.

Bayhealth has also been looking at ways to grow its outpatient services and "shoring up market share" in its area, according to Mr. Tretina. For example, the system built a freestanding emergency room in a northern community that has seen a significant return on investment — it paid for itself in just one year, he said.

In the end, it's all about improving access to care, according to Mr. Tambussi. "You're going to be selfish where you're going to spend your dollars," he said, and organizations should focus on increasing outpatient access, which "doesn't necessarily mean physical structures." Instead, provider organizations should be thinking about things like virtual access and telehealth.

Benefis is doing just that. The system has invested in telehealth services specifically, as telehealth services are reimbursed in the same way an in-person physician visit is in Montana, Mr. Goodnow said.

DuPage Medical Group in Illinois is also looking at ways to build its virtual presence. "Think about the capital expense savings if you can start to see patients in a truly convenient way," Mr. Kasper said. His vision is to put physicians in front of screens in response to nurse practitioners and other providers giving care at every corner through retail clinics.

Mr. Tretina noted that Bayhealth rolled out a home health telehealth service, which was not very successful, which he chalked up to a "generational thing."

"At some point in time when the 55 [year olds] become 65, it will take off," he said. "We're starting with a small capital investment there."

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